Allergan Implant Delivers Dexamethasone for RVO
July 24, 2009
Ozurdex, the intraocular implant approved by the FDA for treatment of retinal vein occlusions (both BRVO and CRVO) has some novel technical advantages and a few interesting implications for treatment of macular edema.
The implant will be injected via a 25 gauge system in the office. The implant will rest quietly in the vitreous cavity and release dexamethasone, after which, the delivery system will “dissolve.” The pharmacokinetics of the drug release are such that there will be an initial high dose release lasting about 2 months, followed by a lower dose release for up to 6 more months as the whole system biodegrades.
Presently, laser photocoagulation is the accepted treatment for BRVO and there is no accepted treatment for CRVO. Retinal specialists have been treating both with “off-label” steroids and anti-VEGF injections over the past few years. The approval of the Ozurdex implicates inflammation linked in the RVO pathway of causing macular edema. Studies are underway to validate the use of anti-VEGF compounds.
Anticipated uses of the implant will also include treatments for diabetic macular edema and macular degeneration as there is growing evidence that inflammation, too, is linked in the processes. Combined therapies of steroid + anti-VEGF compounds are expected to be developed.
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Randall V. Wong, M.D.
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